Capabilities of echography during HIFU ablation steps in prostate cancer patients

Neymark B.A., Besklubova E.V., Tachalov M.A., Klyzhin M.A.

Aim of the study was to estimate the capabilities of echography during the different steps of the prostate cancer HIFU-ablation; to determine the echographic features of prostate after HIFU-therapy and the role of the ultrasound tomography in monitoring of patients after ablation.

The study included 41 patients with clinically localized form of the prostate cancer (T1-2N0M0), which were treated using HIFU-ablation with ultrasound navigation. Prostate cancer diagnosis was carried out in a common way as a result of the elevated PSA level. Ultrasound investigation was done pre-operatively with the aim of selection of patients for HIFU-therapy, also intra-operatively and post-operatively for treatment’s efficacy control. Mean time of the follow-up aer operation was 9 months. The parameters, which were evaluated, were the extent of prostate shrinkage, internal echostructure and vascularization. Prostate shrinkage was evident in 6 first months with the mean final volumes of 68% compared to initial (p< 0.001). Also some other features of ultrasound image were found out: irregularity of the contour, including posterior contour between prostate and rectum, internal heterogeneity with the zones of irregular hyperechogenicity, corresponding to the fibrosis. In some cases microcalcification was to see both periurethral and diffusely, so as the increase in echogenicity of the periprostatic fat. Positive results of the control multifocal biopsies, which were performed in interval of 5-9 months, were found out in 4 patients. Two of these 4 patients were re-treated using HIFU, two other patients were treated using other modalities.

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